World Neurosurg
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Extradural anterior clinoidectomy is an important tool for neurovascular and skull base surgery. This technique is cardinal for expanding access to the proximal carotid artery, optic nerve, sella, and the central skull base. The goal of anterior clinoidectomy is to reveal the more proximal ophthalmic and clinoidal segments of the internal carotid artery (ICA) while skeletonizing the proximal optic nerve. This maneuver expands the opticocarotid and carotid-oculomotor windows and therefore the operative corridor to the interpeduncular cisterns; both the carotid artery and optic nerve are partially untethered or liberated and can be more safely mobilized.
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The pattern of recurrence of large trigeminal neurinomas is analyzed on the basis of experience with 7 cases. ⋯ The cases add further insight to the growth pattern and characteristics of large trigeminal neurinomas.
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The indications and contraindications to the endoscopic transforaminal approach for lumbar spinal stenosis are not well defined. ⋯ We recommend stratifying patients based on the underlying compressive disease and the skill level of the endoscopic spine surgeon to decide preoperatively whether more difficult central or complex foraminal stenotic lesions should be considered for alternative endoscopic approaches.
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To perform an ecological study to analyze the geospatial distribution of neurosurgeons ≥60 years old and compare these data with the spread of 2019 novel coronavirus disease (COVID-19) across the United States. ⋯ Regional COVID-19 hotspots may coincide with areas where a substantial proportion of the neurosurgical workforce is ≥60 years old. Continuous evaluation and adjustment of local and national clinical practice guidelines are warranted throughout the pandemic era.
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An optimized Enhanced Recovery After Surgery (ERAS) program is lacking for adolescent idiopathic scoliosis (AIS). The aim of the present study was to evaluate the impact and feasibility of an optimized ERAS pathway in patients with surgically treated AIS. ⋯ The ERAS pathway is capable of improving the perioperative status of patients with AIS by offering stronger analgesia, faster ambulation, and earlier discharge.